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Colonoscopy

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Colonoscopy is a common, safe test to examine the lining of the large bowel. During a colonoscopy, doctors who are trained in this procedure (endoscopists) can also see part of the small intestine (small bowel) and the end of the GI tract (the rectum). This procedure is often done under sedation to assure maximal patient comfort.During a colonoscopy, the endoscopist uses a flexible tube, about the width of your index finger,fitted with a miniature camera and light source. This device is connected to a video monitor that the doctor watches while performing the test.Various miniaturized tools can be inserted through the scope to help the doctor obtain samples (biopsies) of the colon and to perform maneuvers to diagnose or treat conditions. Colonoscopy can detect and sometimes treat polyps, colorectal bleeding, fissures, strictures, fistulas, foreign bodies, Crohn's Disease, and colorectal cancer. An examination of the inside of the colon, including the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, and cecum (where the small bowel attaches to the large bowel), using an endoscope - a thin, lighted flexible tube inserted through the anus.


For what reason is colonoscopy done?
Colonoscopy might be improved the situation an assortment of reasons. Most by far of colonoscopies are executed as a component of screening programs for colon malignant growth. At the point when improved the situation different reasons, it is frequently done to research the reason for blood in the stool, stomach torment, looseness of the bowels, an adjustment in entrail propensity, or a variation from the norm found on colonic X-beams or a mechanized hub tomography (CT) examine. People with a past history of polyps or colon malignant growth and certain people with a family ancestry of a few kinds of non-colonic diseases or colonic issues that might be related with colon disease, (for example, ulcerative colitis and colonic polyps) might be encouraged to have occasional colonoscopies on the grounds that their dangers are more prominent for polyps or colon malignant growth. How frequently should one experience colonoscopy relies upon the level of the hazard and the variations from the norm found at past colonoscopies. One broadly acknowledged proposal has been that even sound individuals at typical hazard for colon malignancy ought to experience colonoscopy at age 50 and like clockwork from there on, to remove colonic polyps previously they wind up destructive.

Sigmoidoscopy

sigmoidoscopy

Sigmoidoscopy, or "flexible sigmoidoscopy," lets a physician examine the lining of the rectum and a portion of the colon (large intestine) by inserting a flexible tube about the thickness of your finger into the anus and slowly advancing it into the rectum and lower part of the colon. This procedure evaluates only the lower third of the colon. Sigmoidoscopy is often done without any sedation, although sedation can be used if necessary. Various miniaturized tools can be inserted through the scope to help the doctor obtain samples (biopsies) of the colon and to perform maneuvers to diagnose or treat conditions. Flexible sigmoidoscopy can detect and sometimes treat polyps, rectal bleeding, fissures, strictures, fistulas, foreign bodies, colorectal cancer, and benign and malignant lesions. Flexible sigmoidoscopy is not a substitute for total colonoscopy when it is indicated. The finding of a new, abnormally growing polyp during sigmoidoscopy, for example, is an indication for a colonoscopy to search for additional polyps or cancer. Sigmoidoscopy should not be used for polypectomy unless the entire colon is adequately prepared. This procedure should also not be used with cases of diverticulitis and peritonitis.


Upper Endoscopy

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Upper endoscopy allows for examination of the lining of the upper part of the gastrointestinal (GI) tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). In upper endoscopy, the physician uses a thin, flexible tube called an endoscope. The endoscope has a lens and light source, which projects images on a video monitor. This procedure is also referred to as upper GI endoscopy, or esophagogastroduodenoscopy (EGD).
    Upper endoscopy is often done under sedation to assure maximal patient comfort. Upper endoscopy helps the doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It is the best test for finding the cause of bleeding from the upper GI tract and is also more accurate than X-rays for detecting inflammation, ulcers and tumors of the esophagus, stomach, and duodenum. A physician may also use upper endoscopy to obtain small tissue samples (biopsies). A biopsy helps distinguish between benign and malignant (cancerous) tissues. Biopsies are taken for many reasons, and a doctor might order a biopsy even if cancer is not suspected. For example, a biopsy can be taken to test for Helicobacter pylori, a bacterium that can cause ulcers and celiac disease, an inflammatory condition of the small bowel that can lead to anemia, weight loss and diarrhea.
    Upper endoscopy can also be used to perform a cytology (cell) test, in which a small brush is passed through the channel of the endoscope to collect cells for analysis. Other instruments can be passed through the endoscope to directly treat many abnormalities with little or no discomfort. For example, the doctor may stretch a narrow area (a stricture), detect Barrett's esophagus (a possibly precancerous alteration in the esophageal lining), detect and biopsy gastrointestinal cancers, remove polyps (usually benign growths), treat bleeding (with standard cautery or the newer argon plasma coagulation method), and detect and treat symptoms of gastroesophageal reflux disease (GERD).


Endoscopic Retrograde Cholangiopancreatography (ERCP)

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   Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized technique used to study and treat problems of the liver, pancreas and, on occasion, the gallbladder. ERCP is performed under sedation. Generally, the level of sedation for ERCP is deeper than upper endoscopy and colonoscopy due to the complexity and length of the procedure.
   To reach the small passageways, known as ducts, that connect these organs, an endoscope is passed through the mouth, beyond the stomach and into the small intestine (duodenum). The ducts from the liver and pancreas drain into the duodenum via a small opening known as the papilla. A thin tube (catheter) is then inserted through the endoscope into the papilla, thereby gaining access to the common bile duct and pancreatic duct that connect the liver and pancreas to the intestine. A contrast material (dye) is injected through the catheter and flows into the liver and pancreas, outlining those ducts as X-rays are taken. The X-rays can show narrowing or blockages in the ducts that may be due to a cancer, gallstones or other abnormalities. During the test, a small brush or biopsy forceps can be put through the endoscope to remove cells for study under a microscope. In addition, small cylindrical tubes (stents) can be placed within the bile duct and/or pancreatic duct to treat obstructions from either benign or malignant diseases.
   ERCP can be used to diagnose biliary colic, jaundice, elevated liver enzymes, cholangitis (inflammation of a bile duct), pancreatitis (inflammation of the pancreas), and bile-duct (biliary) obstruction due to gallstones (choledocholithiasis) and cancer. ERCP can be used to treat gallstones, malignant and benign biliary strictures, cholangitis, pancreatic cancer and pancreatitis. Traditionally, ERCP was used as both a diagnostic and therapeutic endoscopic tool for evaluating diseases of the bile ducts, pancreas and gallbladder. With improved Magnetic Resonance Imaging (MRI) and the emergence of endoscopic ultrasound (EUS), ERCP is now primarily a therapeutic instrument for treating conditions of the bile ducts and pancreas.
   Cholangioscopy or pancreatoscopy are adjunctive procedures performed during ERCP for selected indications, in which miniature endoscopes are passed through the conventional endoscope, to enable direct visualization of the inner lining of the bile ducts and pancreatic ducts respectively. These procedures permit the endoscopist to obtain tissue specimens directly from the inner lining of the ducts and are also used to treat stones that are difficult to remove using conventional techniques.


Endoscopic Ultrasound (EUS)

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   A flexible endoscope which has a small ultrasound device built into the end can be used to see the lining and wall of the esophagus, stomach, small bowel, or colon. The ultrasound component produces sound waves that create visual images of the digestive tract which extend beyond the inner surface lining and also allows visualization of adjacent organs. Endoscopic ultrasound examinations (also called endoluminal endosonography) may be performed through the mouth or through the anus. EUS is performed under sedation.
   EUS provides more detailed pictures of the digestive tract anatomy. It can be used to evaluate an abnormality below the surface of the inner lining (mucosa) such as a growth that was detected at a prior endoscopy or by X-ray. EUS, because of its ability to examine the wall layers of the GI tract, provides a detailed picture of the growth, which can help the doctor determine its nature and decide on the best treatment. EUS can also be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive, and it can be used to determine the stage of cancers. More importantly, EUS provides a minimally invasive method for acquiring tissue samples from gastrointestinal tumors and lymph nodes that may not be easily accessible by other methods (i.e. radiographic or surgical guidance).
   Fine Needle Aspiration (FNA) can be performed by passing a biopsy needle down the channel of the endoscope and across the intestinal wall under ultrasound guidance to obtain tissue for the diagnosis and staging of cancer. More recently, EUS has emerged as a therapeutic tool for treating both solid and cystic tumors of the pancreas, alleviating intractable abdominal pain secondary to advanced pancreatic cancer, and obtaining access to the bile ducts and pancreatic duct in cases of failed ERCP.

Gastrointestinal endoscopy

   Endoscopy is a significant advancement in diagnosing variety of disorders of the gastrointestinal system The direct observation and visualization of the internal structure by passing a narrow tube in the lumen of our intestine can give us immense information.
Routinely following endoscopic procedures are performed:

1. Gastroscopy- Examination of the Esophagus, stomach and Duodenum

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Also the careful examination of the throat and its structures can also be done Gastroscopy is routinely done for following symptoms: Upper abdominal pain, Acidity not responding to medications, difficulty in swallowing, black colored stools, bleeding in vomiting.The procedure is simple and not very time consuming, usually done on a day care basis without patient getting admitted. The patient need to come on empty stomach and can proceed to one’s work after the procedure



2. Colonoscopy- Examination of the large intestine

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This procedure is done in patients with complaints related to lower side of the abdomen like lower abdominal pain, chronic constipation not responding to medications, recent change in the stool pattern, blood in stools , diarrhea lasting for more than a month etc. The procedure can be done on day care basis. The patient need to consume a liquid medication before the procedure so that the intestines are clean and visualization becomes possible.




Dr. Nachiket Avinash Dubale
Address: Dinanath Mangeshkar Hospital
Telephone: +(91)-9021133704
Timing: By Appointment Only

Address: POONA HOSPITAL
Telephone: +(91)-9021133704
Timing: EVERYDAY 9 AM TO 11 AM
Email: drnachi@yahoo.co.in
Varad Clinic & Endoscopy Centre
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